All About Menstrual Migraines

PMS is not normal. That in no way means you’re abnormal for having it. It means you’re experiencing a hormonal imbalance that’s triggering this monthly avalanche of symptoms, just like many other women around you. Migraines can be a symptom of PMS.

If you are experiencing migraines and you think it is linked to your menstrual cycle you will find a tonne of information in this blog that might give you an insight into why it is happening and what you might be able to do about it. This article is meant as inspiration. Please always consult your GP for medical related issues.

_____

Studies show women are two to three times more likely than men to experience migraines

Although women are more likely to get migraines, most migraine studies have historically been conducted using only male test subjects. 

Experts in science and medicine are finally acknowledging that women’s health has been overlooked and under-studied, said specifically, women in active menstrual years. This makes sense from the point of view of conducting a scientific study. It is important to be able to control the environment and it is widely know a woman who has an active menstrual cycle (not using HBC) has a body with hormonal fluctuations that are uncontrollable and vary greatly from woman to woman. So, it is easier to obtain outcomes, results and conclusions from male test subjects. 

With the wide availability of information on the internet it was so difficult to find solid information about hormone triggered migraines without going for a good dig. Here is what I pulled together for you, there may be more that you need in this but I am a geek and I like to know what is happening in as much depth as possible. Take what you need and leave the rest.

What causes hormone triggered migraines?

Hormone triggered migraines can be one of the symptoms of PMS. Believe me when I say, PMS is not normal. That in no way means you’re abnormal for having it. It means you’re experiencing a hormonal imbalance that’s triggering a monthly avalanche of symptoms, just like many other women around you. Usually this imbalance is caused by too much estrogen, coupled with low progesterone and key micronutrient deficiencies, and it causes your body and brain to go on a completely un-fun rollercoaster ride every month. 

Most of the research I could find state all state two reasons for menstrual migraines. The first reason cites migraines are most probably caused by the rapid drop in estrogen levels that occurs just prior to your period or as a result of prostaglandin levels. For nearly two out of three women with migraine attacks occur around the same time as their period. By definition, if you have migraine attacks that start between the two days before your period and the third day of flow, you likely have menstrual migraine.

Recent data published in the journal Frontiers in Molecular Bioscience, found that sex hormones modify the trigeminovascular system, or the system of neurons that can trigger headaches. These types of hormones which are responsible for making a cells' ion channels control how they react to outside stimuli making them more vulnerable to migraine triggers. According to this journal, changes in estrogen levels in particular can set off these nerves and cause a migraine.

Further research presented at the Experimental Biology 2018 conference offers more insight into the possible estrogen-migraine connection. The study looked at the specific proton exchanger that helps to interpret pain called the NHE1, and found that when levels of it are low, pain signaling in the brain increases—which can lead to migraines. Going back to the rats, results showed that the male rats had a level of NHE1 four times higher than the females which could explain why women are more likely to get migraines in the first place. Additionally, high estrogen levels correlated to low NHE1 levels; that might explain why many women experience migraines when they get their period.

In short the findings suggest women are more susceptible to migraines because the larger magnitude sex hormone fluctuations lead to changes in NHE1 expression, which may leave the brain vulnerable to ion dys-regulation and pain activation.

Perimenopause, Menopause & Migraines

Menopause brings more stable hormone levels. So many women find their migraine attacks decrease or go away once their periods stop. However, the transition to menopause, called perimenopause, can make migraine symptoms worse before they get better. During perimenopause, periods become more irregular, causing unpredictable hormone changes. Overall, estrogen levels start to decline. That sudden drop in estrogen levels, which eventually causes a woman’s periods to stop permanently, can trigger migraine attacks.

Crowd sourced suggestions for working with a Migraine attack

Unfortunately once a migraine is triggered we tend to have to ride it out. I have put a collage of picture together of suggestions from women who suffer with migraines and the things that work for them. It is absolutely imperative that this is used as inspiration only and please, always consult your GP to talk about the best option for you. That goes without saying.

How to work with your cycle to put a stop to menstrual related migraines

We grow into womanhood believing that PMS and the variety of issues that it presents as is an inevitable part of being female. Then so many of us experience it, we believe that must be true. We just accept that once a month for a few days, a week — or even longer — But PMS is not normal. Menstruating women are not destined to suffer before their period. It is possible to work with your cycle so that you can reduce and even eradicate symptoms of PMS, including migraines altogether. It requires a little education and the understanding of how to be in an active and engaged conversation that your body is trying to have with you.

Lifestyle factors that make PMS worse

Modern life brings together a perfect storm of factors that undermine hormone balance and make PMS worse. Here are some of the habits and lifestyle factors that conspire to throw your hormones out of alignment:

1. Stress

We live in a society that places a high value on always being busy. If you ask someone how they’re doing or what’s new and they reply, “I’ve been SO busy,” it often sounds as much like a point of pride as it does a complaint. But we need to reverse our stance on stress. Research shows that the higher the level of our perceived stress, the worse our PMS.

2. Inflammation

Inflammation is a system-wide response to injury or stress, and it can be brought on by a large number of environmental factors, from eating unhealthy foods and being too sedentary to using toxic health and body care products. Prostaglandins are hormone-like substances that control the body’s inflammatory response and we spoke above about prostaglandins link to migraines. (Prostaglandin overproduction is why some women get relief by taking NSAIDs like ibuprofen. NSAIDs block the synthesis of prostaglandins.)

3. Eating too much sugar

Sugar is one of the most inflammatory foods you can eat — and more inflammation means more PMS (see above). 

4. Smoking

Smoking is bad for overall health, of course, including hormone balance. Research shows, women who smoke are twice as likely to develop PMS.

5. Drinking coffee

Coffee fuels prostaglandin production, and increases the risk of cysts, fibroids, and period pain. Coffee also depletes the body of key hormone-balancing nutrients like magnesium. 

6. Carrying Hidden weight

When I say this, I’m not talking about overweight and obesity. While being overweight is associated with a greater risk of PMS, the real problem is how ‘fat’ you are on the inside, which is not reflected in how much you weigh. You can be skinny on the outside and overweight on the inside — this is known in medical literature as being a “medically obese, normal-weight individual,” though a lot of practitioners refer this condition as being “skinny fat” — so you can’t just look in the mirror or step on the scale to know what’s happening on the inside. Your PMS might be telling you to address internal obesity. 

7. Living out of sync with your cycle.

You’ve probably read about the importance of the 24-hour circadian cycle—how important it is to get high-quality, consecutive hours of sleep during the night, for example, and to get some safe sun exposure during the day, etc. But you probably haven’t heard about the importance of living in sync with your 28-day cycle—and, for women, that cycle is just as important to tend to as the circadian cycle. Research shows that our 28-day menstrual cycle affects our brain function, emotions, mood, sensory processing, appetite, and even our perception of pain. If you’re not supporting your body’s unique hormonal needs during each of the four phases of the 28-day cycle, you won’t have healthy, pain-free periods.

Lifestyle Strategies for PMS and Migraines

You can take a multi-pronged approach to ease the symptoms of PMS. This is about learning how to live and participate in the active conversation your body is trying to have with you. Remember, PMS is a signal that your body is using to tell you something is out of whack. It is up to you to learn how to listen and respond to those signals accordingly.

1. Stomp out inflammation.

Eat low inflammatory foods, like cruciferous vegetables, pastured eggs and pastured animal proteins, and nuts and seeds. Reduce the amount of sugar you eat or eliminate it altogether. A high-sugar diet drives up the production of advanced-glycation end products, which contribute to inflammation. Two foods that have been shown to help specifically with prostaglandin reduction are pomegranate and small, oily fish that contain high levels of inflammation-fighting omega-3 fatty acids.

2. Make “organic” and “clean” the main part of your life.

When you’re standing in the grocery aisle or at the makeup counter and the clean products and organic foods are more expensive than the conventional option, it can be easy to make the wallet-friendly choice. But what you need to keep in mind in these moments is the true cost of the choice you’re making. The toxins in these foods and products come into direct contact with the body and alter endocrine function, making period problems like PMS worse. You may save at check-out, but you are ultimately paying with your health. Eat organic and clean whenever possible. 

3. Give up coffee.

I know. It is the worse one for most women to hear but it will help greatly if you can eliminate it altogether. I wrote an instagram post that goes into this in depth and solutions about what you can do if you can’t imagine going cold turkey….but seriously, skip that coffee and that includes caffeinated tea, too. 

4. Improve your health from the inside out. 

You might look lean in the mirror, but if you don’t exercise (hence, you don’t have much lean muscle mass), and if you eat a high-sugar diet and/or you don’t have enough phytonutrient-rich vegetables on your plate, you might have the bloodwork profile of someone with overweight or obesity—and being overweight or obese is strongly correlated with PMS. When you start correcting what’s going on internally, you can see a reduction in symptoms

5. Find what relaxes you… and make it a regular part of your life.

In the medical literature, high levels of stress are associated with more severe PMS. The time for stress reduction is now, not when you finish this big project or after that big presentation. Because guess what? When you finish those things there will just be more to do. The time is now. Your health depends on it.

6. Start Cycle Syncing

All of the biohacks I just mentioned will only get you so far if you don’t start to live in accordance with your cycle. Eating and exercising for each week-long phase of your 28-day cycle is the foundation of feeling better and having a symptom-free period. For too long, we’ve been living the same way day in and day out. This works for men, but not for women. Syncing your cycle can help you live in rhythm with your cycle and give you access to more energy for life, work, relationships and more. 

Getting educated about your cycle is an imperative. I would highly recommend you keep an eye out for my online workshop PERIOD POWER. It is a quick blast of all the foundational information you need to get you on track to having that conversation. 

7. Get More Nutrients.

Experts also believe that nutrient deficiencies play a role in PMS symptoms. Research has shown a connection between low levels of vitamin D, calcium, and magnesium and PMS symptoms. Studies also suggest that supplementing with magnesium and vitamin B6 can make a significant difference in the severity of PMS. Literally everything I read stated to supplement with Magnesium from day 15 of your cycle.

8. Pelvic Floor Physiotherapy

A really interesting study I read found that some women who experience menstrual related migraines find relief through pelvic floor physiotherapy, specifically releasing tension and excess stress that can often be held in the pelvic floor for a myriad of reasons. I would highly recommend seeking out a PF physio in your area for more investigation.

Well, I hope this gives you a tonne a information to help you support yourself a little better during your cycle and during a migraine attack

Much Love,

Jenny